老年新鲜无移位型股骨颈骨折治疗的临床研究
【摘要】 目的 观察利用AO中空加压螺钉内固定治疗和传统牵引治疗老年新鲜无移位型股骨颈骨折治疗的临床疗效。方法 我科自2006年3月至2009年5月共收治新鲜无移位型股骨颈骨折患者47例,将其随机分为观察组和对照组:观察组24例,行早期AO中空加压螺钉内固定术治疗;对照组23例,行托马氏架牵引治疗,术后随访12~48个月,观察临床疗效。结果 观察组治愈20例,有效3例,1例无效,总有效率为95.8%;对照组治愈12例,有效5例,无效6例,总有效率为73.9%。两组对比有显著性差异(P＜0.05)。结论 对于老年新鲜无移位型股骨颈骨折,采用AO中空加压螺钉内固定治疗较传统牵引治疗,具有更好的临床疗效,值得推广应用。
【Abstract】 Objective To observe the clinical effects of AO cannulated screw fixation and traditional hauling for treatment of fresh femoral neck fracture in old patients.Methods 47 cases came to our department between March 2006 and May 2009 were devided into two groups randomlyof which 24 cases(observation group)were underwent AO cannulated screw fixation,23 cases(control group)Thomas’s frame traction therapy,all of the cases were followed up for 12-48 months,observe the clinical effect.Results In observation group 20 cases were cured,3 cases effective,1case uneffective,the total effectiveness is 95.8%and in control group 12 cases were cured,5 cases effective,6 cases uneffective,the total effectiveness is 73.9%.There was a significant difference between the two groups(P＜0.05).Conclusion The usage of AO cannulated screw fixation hadbetter clinical effect for treatment of fresh femoral neck fracture in old patients.so it is worth to promote.
【Key words】Cannulate screws; Femoral neck fractures; Old patients; Fixed treatment
随着我国进入人口老龄化社会,由骨质疏松所致骨折的发病率逐年上升,而股骨颈骨折是临床上较为常见的疾病,也成为了使患者致残率和死亡率高的主要原因[1]。对于无移位型股骨颈骨折患者常采用牵引治疗,然而这种方法不但延长了老年患者的卧床时间,而且容易产生下肢深静脉栓塞和褥疮等并发症,并且该种治疗还有骨折产生再移位的危险,据报道无移位骨折的再移位率可为15%[2]。目前,临床上对于无移位型股骨颈骨折患者在全身情况允许时均采取手术治疗。为了比较手术和传统牵引治疗老年新鲜无移位型股骨颈骨折治疗的临床疗效,将来我科就诊的新鲜无移位型股骨颈骨折患者47例分为随机观察组和对照组,分别行早期AO中空加压螺钉内固定术治疗和托马氏架牵引治疗,现将结果报告如下。
1 资料与方法
1.1 临床资料 2006年3月至2009年5月我院收治股骨颈骨折患者47例,均为闭合性损伤,跌伤22例,车祸伤17例,坠落伤8例,都为伤后12 h内诊治。将其随机分为观察组和对照组:观察组24例,其中男14例,女10例;年龄62~78岁,